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National Nurse Magazine April 2010

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CE Home Study Course Hospital Magnet Status Impact on RN Autonomy and Patient Advocacy Hospitals are increasingly looking to the American Nurses Association's magnet hospital program as a way to boost their reputations. But what exactly are magnet hospitals, and how does magnet hospital status affect RNs and patients? To find out, take this home-study course and submit the attached quiz by mail for 2 continuing education credits. DESCRIPTION: This home study examines the impact of hospital magnet designation on the independent professional judgment of direct-care registered nurses and their right and duty to advocate for their patients. Hospital and medical group revenue and profit were generated by providing services to meet patient needs as determined necessary by physicians and other professional caregivers, including direct-care registered nurses. Fee-for-service financing of hospital care delivery generally aligned the interests of physician and hospital providers with patients in ways that promoted trust, continuity, and financial incentives to provide necessary care for patients. In this economic scheme, the original magnet hospitals were recognized on the basis of superior RN staffing ratios and significant administrative support for direct-care RNs. The staffing ratios and administrative support provided the necessary foundation for effective, RN-friendly scheduling policies and a nurse-patient relationship which allowed competent practice under professional standards of care. As described by the American Academy of Nursing in 1983: Background n 1990 the american nurses association (ANA) approved a proposal that recognized excellence in nursing services. This was based on an earlier research done by the American Academy of Nursing on practice in U.S. hospitals. The variables used in the study were called "Forces of Magnetism" and the facilities were called "Magnets" because they allegedly attracted and retained registered nurses. The Magnet Recognition Program was developed by the American Nurses Credentialing Center (an ANA subsidiary) to recognize "health care organizations that provide nursing excellence." The proIn magnet hospitals there is a low patient-to-registered nurse gram also provides a vehicle for "successful" nursing practices and ratio, with adequate staff to provide total nursing care to all strategies. patients. The Magnet program is based on quality indicators and stanFurthermore, the quality and complexity of patient care needs dards as defined in the ANA Scope and Standards for Nurse Adminare taken into consideration when the staffing is planned; this is istrators (2004). The Magnet designation process includes 14 important in minimizing stress. The nurse does not feel overqualitative factors in nursing also known as the 14 "Forces of Magworked and has an opportunity to meet all of the patient's needs netism" which were first identified through the research done in — psychological, interpersonal, and physical. There is also time for 1983 (See Appendix A). The stated intent is to provide "consumers interaction among nurses so that continuity of care is insured and with the ultimate benchmark to measure the quality of care that nurse-to-nurse consultation is encouraged. The nurses express they can expect to receive." great satisfaction in their opportunity to provide good care and in In an updated (2009) edition called Nursing Administration: administration's support for it. Scope and Standards of Practice, nurse administrators are required to embrace the concepts reflected in the Five Model The 1983 Study by the AAN interviewed nurses Components associated with the Magnet Recogniworking for hospitals that were part of the original tion Program. They include: Transformational Leadmagnet selection process who summarized their Submitted by ership; Structural Empowerment; Exemplary experiences by identifying the most important facthe Joint Nursing Professional Practice; New Knowledge, Innovation, tors in promoting recruitment and retention of staff. Practice Commission and Improvements; and Empirical Quality Results. The key factor and driving force for all factors was and Hedy Dumpel, The Five Model Components incorporate the 14 "a nurse-patient ratio which assures quality patient RN, JD qualitative factors in nursing. care," followed by "flexible staffing to support patient care needs," "flexible scheduling," and the practice of Provider Approved by the California "primary nursing." Staffing ratios were the absolute HISTORY OF MAGNET HOSPITAL RECOGNITION Board of Registered and mandatory condition of magnet hospital nursing The Beginning—"Forces of Magnetism" Nursing, Provider service that enabled nurses to care for their patients Aligned with Patient Interests #00754 for 2.0 in a manner consistent with their professional practhe magnet program began in the early 1980s contact hours (cehs) tice obligations, ethical norms, and personal career when health care provider services were funded by mission as registered nurses. The AAN summarized fee-for-service and indemnity insurance methods. I 22 N AT I O N A L N U R S E W W W. N A T I O N A L N U R S E S U N I T E D . O R G APRIL 2010

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